Development of a predictive formula for arterial complete occlusion pressure in upper and lower limbs during blood flow restriction

Blood flow restriction (BFR) is an innovative technique widely utilized in sports and rehabilitation for enhancing muscle strength and hypertrophy with low-load exercises. A critical factor for its efficacy and safety is determining the appropriate limb occlusion pressure (LOP). This study aimed to develop predictive formulas for estimating LOP in the upper and lower limbs based on anthropometric and hemodynamic variables, enabling a standardized and personalized approach to BFR application. A cross-sectional observational study was conducted with 39 healthy participants aged 18–40 years. Variables such as systolic and diastolic blood pressure, limb circumferences, and BMI were analyzed. LOP was measured by two independent raters using Doppler ultrasound, and multiple linear regression models were developed for each limb. Results showed that systolic blood pressure and limb circumferences were key predictors for LOP in both upper and lower limbs, explaining 39.5% and 40.9% of the variance, respectively. BMI was not a significant predictor in either model. High intra- and inter-rater reliability of LOP measurements was demonstrated, with intraclass correlation coefficients (ICC) of 0.99 for intra-rater and 0.98 for inter-rater reliability, indicating excellent agreement. The standard error of measurement (SEM), ranged from 1.08 to 4.10 mmHg across measures, while the minimum detectable change (MDC), ranged from 2.99 to 11.37 mmHg. The findings provide a reliable framework for personalizing BFR protocols, improving safety and efficacy while reducing variability in clinical and sports settings. Future research should validate these formulas in diverse populations and explore their application during exercise. • Predictive formulas were developed to estimate arterial occlusion pressure. • Systolic pressure and limb circumference were the main predictors. • The formulas explained 39.5% and 40.9% of the variance in upper and lower limbs. • High intra- and inter-rater reliability was demonstrated (ICC = 0.98-0.99). • Findings enhance personalization and safety of BFR protocols